Provider Demographics
NPI:1932796257
Name:SIMMONS, JANISA CAMILLE
Entity Type:Individual
Prefix:PROF
First Name:JANISA
Middle Name:CAMILLE
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:735 THE FALLS PKWY
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-8241
Mailing Address - Country:US
Mailing Address - Phone:407-289-7152
Mailing Address - Fax:
Practice Address - Street 1:735 THE FALLS PKWY
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-8241
Practice Address - Country:US
Practice Address - Phone:407-289-7152
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-22
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula